MEDICARE: SYOSSET SPEECH & HEARING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	231H00000X	Audiologist

General Provider Information

NPI Number	:	1326114430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYOSSET SPEECH & HEARING

Provider Business Mailing Address
First Line	:	175 JERICHO TPKE STE 103
Second Line	:	SYOSSET SPEECH & HEARING
City	:	SYOSSET
State	:	NY
Zip	:	11791-4546
Country	:	US
Telephone Number	:	516-364-1234
Fax Number	:	516-364-3132

Provider Business Practice Location Address
First Line	:	175 JERICHO TPKE STE 103
Second Line	:	SYOSSET SPEECH & HEARING
City	:	SYOSSET
State	:	NY
Zip	:	11791-4501
Country	:	US
Telephone Number	:	516-364-1234
Fax Number	:	516-364-3132

Authorized Official
Title or Position	:	DIRECTOR AUD & SPEECH PATHOLOGIST
Name	:	DR. ARTHUR PODWALL
Credential	:	PHD
Telephone Number	:	516-364-1234

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/11/2008

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Practice Location Address:

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1245306356 — DR. PAULA LAMENDOLA AU.D.
Practice Location Address:

175 JERICHO TPKE STE 103 , SYOSSET SPEECH & HEARING CENTER
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Practice Location Address:

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1497977185 — DR. ANGELA MOURADIAN DDS
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Practice Fax:

Directions to “SYOSSET SPEECH & HEARING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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